At last: the truth about Stafford hospital starts to go mainstream

Last Monday, I attended a semi-clandestine meeting in Stafford. This meeting was to allow Guardian journalist Randeep Ramesh to meet Stafford hospital staff and some of those who have campaigned to save the hospital or to correct the culpably inaccurate portrayal of Stafford as a hospital that ‘killed’ hundreds of its patients, as preparation for an article that would finally, finally, begin to bring the long-overdue refutation of the misleading narrative into the mainstream.

This article, which has now been published and which became the ‘Society’ sections most read of the preceding 24 hours within a couple of hours of its publication, represents an important step in the right direction, as the supposed ‘facts’ of Stafford begin to be challenged in the professional media.

As I predicted a couple of weeks ago, the media and the government over-reached themselves when they lied about the Keogh report, before its publication, by claiming that it would highlight 13,000 deaths in just 14 NHS hospitals.

The Guardian had planned to run a major article on the illegitimacy of the claims about mortality at Stafford on 5 July, to coincide with the NHS’ 65th birthday, but one reporter had persuaded the responsible editor that the death claims could be trusted.

However, that changed last week. The fact that Bruce Keogh himself, even before his report was published, disowned these deliberately-hysterical claims in the clearest possible terms, and the report when published was even more blunt, made it impossible to doubt, with credibility, that mortality statistics are deliberately being distorted by media and government as a propaganda weapon against the NHS.

It’s taken long enough. But it’s hard to mistake the import of this statement from Keogh’s report:

it is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths

The Guardian published a story quickly highlighting the nonsense of the pre-Keogh propaganda – yet finished its article by failing to make the obvious logical connection: that if the claims about the 14 hospitals were nonsense being abused for ideological purposes, then the same was very likely to apply to the claims around Mid Staffs. The article concluded:

The Francis report came close to suggesting minimum staffing levels and showed how inadequate staffing levels at Stafford hospital were a key factor in what the then NHS watchdog the Healthcare Commission estimated to be between 400 and 1,200 extra deaths between 2005 and 2009.

The article’s author got his facts hopelessly wrong, too, since the HCC never at any point published any such estimate, and the figures were ‘leaked’ by an unknown source to newspapers who immediately treated it as fact. But in the article published today, the Guardian finally started to join the dots and get the right resulting picture:

It also quotes Professor Brian Jarman as finally stating clearly in print that the use of his statistics to claim avoidable deaths is an abuse of the figures, which is well past due.

I would have loved to see a much more appropriately emphatic statement. There is no ‘may have been’ – the death figures were unfounded when they were leaked, and the way in which the right-wing media – and politicians as senior as David Cameron – have regularly repeated them as fact is nothing short of disgraceful. But it’s a start.

The article confirms a number of facts that were first publicised on the SKWAWKBOX, against the prevailing media portrayal:

that the sensationalist claims of patients routinely drinking from flower vases was impossible. There may have been one isolated instance of a confused patient finding a vase and drinking from it because he was on restricted fluids for medical reasons – but as a generality it could not happen, as vases were not allowed on wards since the 1990s.

that claims that receptionists performed ‘triage’ (emergency medical assessment) on A&E patients is nonsense: receptionists entered their name against records because the system would not allow them to complete a registration unless there was a name in the name field.

that a big part of Stafford’s inflated HSMR figure was down to inadequate coding.

that claims of ‘gaming’ of stats, and particularly the Z51.5 ‘palliative care’ code, were unfounded – the under-used code was merely corrected and was within expected limits.

and more. From a purely personal point of view, it would have been nice to see this blog credited as the original source of the information (the Guardian has slipped a few times in that regard in the last couple of weeks), but I understand that in this case it’s simply an editing error that should be corrected on Monday.

All in all, Randeep Ramesh has done a very good job of presenting a corrected view of both the situation at Mid Staffs and the way the government and media have misused NHS mortality statistics – and he deserves great credit for being the first high-profile journalist to both understand the true situation and to be prepared to publish on it.

This is a vital first step in correcting a massive wrong, and putting right a deep and vast deception perpetrated on the British public.

But there is much further to go. The people of Stafford still face losing their hospital and services when the ‘Trust Special Administrators’ announce their recommendations this Wednesday, and are likely to have to resort to judicial review to have a chance of saving services that the misrepresented statistics have been used to weaken and prepare for sell-off, so I urge you to support their cause in any way you can – because it’s your cause, too, and your hospital will be next, sooner or later.

It’s now also up to other media outlets to grasp the nettle and to start to correct their own misrepresentations and those of the obvious culprits like the Mail, Telegraph and Express who will never even consider correcting their distortions – and of course of Cameron, Hunt and co who have exploited them without conscience at every opportunity – and I understand that other media are in fact now lining up to take their turn at this story now that the Guardian has broken the ‘MSM’ (mainstream media) ice.

Anything I see in that regard will, of course, be flagged on this blog. But please make sure to tweet, facebook and email far and wide any articles you see yourself, as I might miss them – and it’s vital that we don’t miss this opportunity both to correct the distorted picture that has hitherto prevailed, and to put the blame for the distortion where it belongs: squarely on the shoulders of Cameron and his gang of mini-Goebbels, the complicit media and others who have all too readily screamed ‘needless deaths’ to undermine our NHS.

I expect that this Cure group will take great offence to the article and redouble their efforts against the hospital, as well as you and other people who are writing the truth.

Hopefully you’ll get named recognition as well, you’ve put a lot if effort and research in and it’s only right that you’re credited and acknowledged. You might even get an apology off that MP soon, but I wouldn’t hold your breath! 😛

Sadly the only recognition from the Guardian that I can find so far is this from a poster:

Whilst thanking Ramesh, it’s very, very important to actually thank the man who has doggedly been dealing with this statistical mis-information for a very long time. His name is Steve Walker. His blog is The Skwawkbox. Do take time to have a read.

At last you’ve been vindicated for insisting on the truth. This is great news, Steve, well done! I’m not in the least surprised at JB’s lots’ response of ‘disgusting’. They really are a narrow minded shallow group who claim not to be political yet pounce on any hint of criticism of Hunt. JB amazingly responded to a tweet of mine which was not directly aimed at her but at someone (a male nurse) trying to reason with her and a few of her sycophants. He was pointing out that the Health Bill removed the SoS’s direct responsibility for the NHS and I agreed and mentioned how Monitor’s role was now purely to enforce competition. She tweeted to tell me that it was Labour who started Monitor. She obviously couldn’t resist making this petty political point and it amused me because a couple of weeks ago when I made an attempt to engage her in debate she blocked me so she must have gone to the trouble of unblocking me in order to make her rather silly point. I’ve noticed how these people suck up to Hunt and Edwina Currie and seem obsessed with you, Steve, calling you a ‘loony leftie’. Now a reputable newspaper is saying what you’ve been trying to tell them for so long and they just don’t have the grace to acknowledge they were wrong . I’m so pleased you’ve won this battle!

We truly cant thank you enough for your support and your dogged persistance at getting the TRUTH our there. As you say, the battle is far from over at Stafford, but maybe we can regain some dignity in the eyes of the wider public.

Well Done! Steve for your doggedly reporting and informing us of the true facts.. I have shared this on facebook “Well done Steve Walker for persisting with the NHS issues showing not only that the death figures are flawed but the reporting of incidents in the hospital is also flawed and for getting it into the mainstream media”
I like many others thank you!

Steve: I have tried to pass this information to you before, but have been unsuccessful in uploading as the site suddenly disallows me to log it.
So I am trying it once more for you to see what is happening specifically with our ambulance service here in Gloucestershire but also elsewhere in Britain, obviously with varying outcomes.
It is directly linked with the A&E problems as with the out of hours service.

Now perhaps some of those people who yawned every time I banged on about this whole sorry saga and pointed them to your blog will realise that they REALLY shouldn’t always believe these sensationalist headlines and do some of their own investigating – or just read your blog!! Well done, Steve – I truly bless the day that I came across your blog. Keep up the good work.

The evidence gathered by the Inquiry shows clearly that for many patients the most basic elements of care were neglected. Calls for help to use the bathroom were ignored and patients were left lying in soiled sheeting and sitting on commodes for hours, often feeling ashamed and afraid. Patients were left unwashed, at times for up to a month. Food and drinks were left out of the reach of patients and many were forced to rely on family members for help with feeding. Staff failed to make basic observations and pain relief was provided late or in some cases not at all. Patients were too often discharged before it was appropriate, only to have to be re-admitted shortly afterwards. The standards of hygiene were at times awful, with families forced to remove used bandages and dressings from public areas and clean toilets themselves for fear of catching infections.

Speaking at the publication of his final report, Robert Francis QC said:

“I heard so many stories of shocking care. These patients were not simply numbers they were husbands, wives, sons, daughters, fathers, mothers, grandparents. They were people who entered Stafford Hospital and rightly expected to be well cared for and treated. Instead, many suffered horrific experiences that will haunt them and their loved ones for the rest of their lives.”

The Inquiry found that a chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care. Morale at the Trust was low, and while many staff did their best in difficult circumstances, others showed a disturbing lack of compassion towards their patients. Staff who spoke out felt ignored and there is strong evidence that many were deterred from doing so through fear and bullying.

Robert Francis QC added:

“It is now clear that some staff did express concern about the standard of care being provided to patients. The tragedy was that they were ignored and worse still others were discouraged from speaking out.”

The Inquiry concluded that a number of the deficiencies at the Trust had existed for a long time. Whilst the executive and non-executive Board members recognised the problems, the action taken by the board was inadequate and lacked an appropriate sense of urgency.

The Trust’s board was found to be disconnected from what was actually happening in the hospital and chose to rely on apparently favourable performance reports by outside bodies such as the Healthcare Commission, rather than effective internal assessment and feedback from staff and patients. The Trust failed to listen to patients’ concerns, the Board did not review the substance of complaints and incident reports were not given the necessary attention.

Problems at the Trust were exacerbated at the end of 2006/07 when it was required to make a £10 million saving. The Board decided this saving could only be achieved through cutting staffing levels, which were already insufficient. The evidence shows that the Board’s focus on financial savings was a factor leading it to reconfigure its wards in an essentially experimental and untested scheme, whilst continuing to ignore the concerns of staff.

Announcing the Inquiry findings, Mr Francis told staff and patients:

“A number of staff and managers at the hospital, rather than reflecting on their role and responsibility, have attempted to minimise the significance of the Healthcare Commission’s findings. The evidence gathered by this Inquiry means there can no longer be any excuses for denying the scale of failure. If anything, it is greater than has been revealed to date. The deficiencies at the Trust were systemic, deep-rooted and too fundamental to brush off as isolated incidents.”

1) Francis only heard from about 16 patients/relatives in total, so in saying he heard ‘so many’ stories, he might have been indulging in a little artistic licence. Since much of the evidence was given by Julie Bailey, whose story about her mother’s care is full of holes and deeply problematic, a generous pinch of salt should be applied.

2) That there was poor care in some wards is not at issue. What IS at issue are the reasons it happened – which Francis named as understaffing, not lack of effort or compassion – and whether it caused an ‘excess’ of avoidable deaths.

The answer to that is a resounding ‘no’. There is no evidence at all to support it, much as some would like there to be.

That’s all I can find in the witness list. This really is a case of a small number of people – whether their complaints are genuine or not – being exploited (willingly in this case) by other interests, with the grossly-inflated mortality stats as fuel.

I think you will find that there were more than that in Francis 1, but I do not know how many interviews were involved. There was a big campaign to bring in letters, which were used in the second volume, I am not sure what the criteria for inclusion in the report was. I know that the letter I sent was not included but that may because mums treatment came before the specified time, or it may be because I made it clear that I had reservations about the whole exercise.

With Francis 1 there was a real sense that it was peoples public duty to share experience!

“The Guardian had planned to run a major article on the illegitimacy of the claims about mortality at Stafford on 5 July, to coincide with the NHS’ 65th birthday, but one reporter had persuaded the responsible editor that the death claims could be trusted”. I’d just love to know who that reporter was!

It would be unfair to try – and no point. The article now has changed the basis of debate. No one can ever again present the excess deaths at Stafford as “fact”. The article – good though it was is still tip of a very large iceberg of evidence, but it has done what it needed to do.

Reblogged this on Oprichnik Rising and commented:
The Stafford NHS scandal. Nothing more than cheap propaganda misusing statistics to help along the ideological privatisation of the National Health Service. Finally we get a mainstream media organisation brave enough to state this.

Dear Steve, thanks for your tireless work in exposing the shamelessly manipulative shenanigans at Stafford Hospital – I’m sure it’s only down to the quality of your research and your dogged persistance that at last it’s gone mainstream. One head off the hydra and a number of others yet to go. We so need people like yourself to defend the truth; long may you continue.

Hi Steve,
I’ve been reading your blog for some time now and realise the utter vindictiveness of some people’s behaviour toward you, it is outrageous. I have a relative who works long and hard in a professional basis at Stafford Hospital that is why I have said nothing for so long, but the lies and untruths get my blood boiling in anger at the bias way Stafford Hospital is pushed by the media.
We know that there were serious faults at Stafford, there are serious faults in all hospitals as we see lately, but the claims of deaths due to lack of care are just fictitious but they are just recycled by the media without any redress, they are allowed to repeat the lies again and again without redress and are never tackled over the lies. If Stafford is mentioned the ‘lack of care death’ figures are used again without question and if any comment is needed the media only ask for a one sided opinion from Cure, never even trying to ask any of the 51,000 who marched and had such good care whilst in the hospital.
Sometimes my relative comes home sad and dejected wondering if the caring hospital where they work professionally all day to help people become better and lead a normal life is really the hell hole Nazi style concentration camp the press would have people believe.
As a silent supporter of you and your very gallant and truthful way you fight for truth and fairness you have my support and if some people out there are throwing heaps of dirt and lies onto you, you know that there are many of us out here in cyber land who are brushing away the dirt of lies heaped on you so that you can keep speaking the truth.
I wish you well and keep fighting.

Mid Staffs and Stafford (that’s the people not just the Trust and hospital) have every reason to be very grateful for your efforts Steve. As you say, this is not the end or the beginning of the end, maybe the end of the beginning. Thank you.
Can you imagine the financial impact on the Trust of having to cope with all this (on top of being underpaid on PBR as I have previously mentioned on this blog). At the very least the presence of the TSA is built on a false premise (within the rather bigger false premise which is the internal market in healthcare).
If the TSA was REALLY brave he’d conclude that the best (by far) and cheapest (probably) solution in the medium term for the whole of Staffordshire and the Black Country (over 2m people and not that many hospitals) is to leave secondary care much as it is and let everyone in primary and secondary care start seriously collaborating (he won’t).

Seems the BBC have not got the memo yet?
“Mr Francis’s inquiry, into one of the biggest scandals in the history of the NHS, looked at why the problems at Stafford Hospital, where hundreds of needless deaths were caused by abuse and neglect in 2005-08, was not picked up earlier.”

I get the feeling they would not care, and certainly do not want the readers “put straight” hence the no author article and it seems no have your say enabled. It took them long enough yesterday to context the 36 wards with the number of wards it was out of with regards to the headline “Friends-and-family patient test failed by 36 wards” … I guess saying 0.8% of wards failed was not the headline they were looking for?

No probs Steve, the only reason I was paying close attention was because before the release of the figures/results Eamonn Holmes on Sky News kept saying coming up at 9.30 live on Sky News the results of the family and freinds survey EXPECTED to show shocking new levels in poor health care … giving me an “Expected to show 13,000 needless deaths” deja vu moment.

Seems the Beeb has altered the Mid Staff article now to read:
“Before being put into administration, a public inquiry, led by Robert Francis QC, was triggered by a higher than expected number of deaths at the hospital.”